Newly Graduated Nurses' Experiences of Introduction to The

ISSN: 2469-5823 Ingvarsson et al. Int Arch Nurs Health Care 2019, 5:119 DOI: 10.23937/2469-5823/1510119 Volume 5 | Issue 1 International Archives of Open Access Nursing and Health Care ORIGINAL ARTICLE Managing Uncertainty in Nursing - Newly Graduated Nurses’ Experiences of Introduction to the Nursing Profession Elina Ingvarsson, BSc, RN1, Josefin Verho, BSc, RN1 and Kristina Rosengren, PhD, RN1,2* 1 Check for Sahlgrenska Academy, Institute of Health and Care Sciences, University of Gothenburg, Sweden updates 2Department of Internal Medicine, Sahlgrenska University Hospital, Mölndal, Sweden *Corresponding author: Kristina Rosengren, PhD, RN, Associate Professor, Sahlgrenska Academy, Institute of Health and Care Sciences, University of Gothenburg; Department of Internal Medicine, Sahlgrenska University Hospital, Sweden, ORCID iD: 0000-0002-3221-2062 Abstract Introduction Background: The introduction to nursing, which is the After a minimum of three years of university studies, conversion of theoretical knowledge into practice skills in newly graduated nurses are eager to start working. complex healthcare settings, is emphasized as difficult However, future nurses express anxiety about entering due to patient safety. Therefore, the aim of this study was to describe newly graduated nurses’ experiences of the nursing profession, which is why the introduction introduction to nursing in a medical department (medical, to the nursing profession is important to ensure patient emergency) at a university hospital in western Sweden. safety [1,2]. The current study intends to broaden the Method: A manifest qualitative content analysis with an knowledge regarding this introduction to improve inductive approach was used based on five semistructured newly graduated nurses’ work environment and ensure interviews with newly graduated nurses who work in a a high quality of care. medical department at Sahlgrenska University Hospital in Gothenburg, Sweden. Background Findings: One main category was found, managing A nursing education develops knowledge regarding uncertainty in the nursing profession, which includes three health and well-being and is an art that uses objective subcategories, namely, being humble as a newly graduated nurse, being adaptable as a newly graduated nurse and (quantitative) and subjective (qualitative) perspectives. being a staff member instead of a nursing student. This Theoretical models prepare nursing students to under- category and these subcategories are described in the stand context and behaviors. However, practical wis- results. dom and tacit knowledge grows through experience, Conclusion: The transition from education to registered which is why it is difficult to learn in only a theoretical nurse is a difficult step due to the anxiety that stems from perspective [3,4]. Therefore, theoretical and practical making mistakes regarding limited experience related to the demands and requirements of the job. Therefore, stan- knowledge are required to transform and translate dardized (routines, guidelines) and individualized (expe- nursing studies into clinical settings [5]. The opportu- riences) introductions facilitate patient safety. Moreover, nities for nursing students to participate in a peer men- person-centeredness ensures that every nurse is a capable toring relationship improve nursing, and mentorship person with resources to use in health care, i.e. a partner- helps students to fulfill future professional responsibil- ship within a healthy working environment that transforms novices to experts in nursing. ities by developing skills that improve communication and critical thinking [6]. Moreover, to facilitate future Keywords nurse’s assignments in health care, educators in uni- Introduction, Mentorship, Newly graduated nurse, Supervi- versities and clinical settings need innovative pathways sion, Transition, Person-centeredness, Qualitative content that bring students and clinicians together as team analysis Citation: Ingvarsson E, Verho J, Rosengren K (2019) Managing Uncertainty in Nursing - Newly Gradu- ated Nurses’ Experiences of Introduction to the Nursing Profession. Int Arch Nurs Health Care 5:119. doi.org/10.23937/2469-5823/1510119 Accepted: March 23, 2019: Published: March 25, 2019 Copyright: © 2019 Ingvarsson E, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Ingvarsson et al. Int Arch Nurs Health Care 2019, 5:119 • Page 1 of 8 • DOI: 10.23937/2469-5823/1510119 ISSN: 2469-5823 members to overcome the gap between theory and medical department (medical, emergency unit) at a practice [4]. Nurse’s had several task, one is preven- university hospital in western Sweden. tative care [7,8]; however, when more care is needed, nursing must be performed in collaboration according Method to the team’s practical, empirical and personal knowl- Settings edge [4,9]. Sahlgrenska University Hospital [17] is one of the The complexity between theory and practice chal- largest workplaces in the county council of Västra lenges newly graduated nurses. Entering the nursing Götaland with approximately 16,000 employees who profession is described as a reality shock, and theoreti- are divided into 120 departments and located at four cal education is difficult to address in a practical setting. different hospitals in the Gothenburg area, namely, Nurses acquire nursing knowledge and skills (knowing Sahlgrenska Hospital, Eastern Hospital, Mölndal Hospital how) by learning the theory (knowing that) that is devel- and Högsbo Hospital. Sahlgrenska University Hospital oped during nursing education and later in clinical prac- offers employed newly graduated nurses a structured tice according to a nurse’s personality. This transition is introduction (basic year) with supervision, mentorship described in the five stages of novice, advanced begin- and clinical education at two work places (surgical, ner, competent, proficient and expert [5]. Being trans- medical department). The medical department where formative, integrative and representative, competences the study was conducted includes two (medical ward, include support, confirmation, participation, and prob- emergency unit) units. lem solving in the daily work as a nurse [7,8]. Moreover, a high quality of care focuses on patients’ medical issues Design and their experiences, as well as resources regarding This study used content analysis, a qualitative meth- health and well-being [10]. Although nursing is unpre- od that involves an inductive approach, to increase the dictable and demanding due to a variety of health prob- understanding of newly graduated nurses’ voices, views lems and patients of all ages, teamwork is needed to and thoughts about their introduction to the nursing provide a high quality of care [11]. According to the re- profession. This method reveals conflicting opinions search [12], newly graduated nurses’ experience emer- and unresolved issues regarding the meaning and use gency care as challenging, exciting and intimidating due of concepts, procedures and interpretation. Content to rapid changes with a high degree of problem solving. analysis illustrates the use of several concepts that re- In addition, newly graduated nurses’ experience anxi- late to research procedures to achieve trustworthiness, ety and reduced self-confidence regarding their limited credibility, dependability and transferability [18,19]. A knowledge and skills; therefore, continuous supervisors qualitative research design that relies on trustworthi- and/or mentors are significant to the introduction to the ness, transparency, verification, and reflexivity and that nursing profession [13]. However, experienced nurses is “information driven” can be helpful when developing (supervisors) use different skills (tacit knowledge) in insightful and appropriate interpretations within nurs- nursing, which can be confusing and can cause uncer- ing [20]. An inductive methodological approach was tainty among newly graduated nurses. Therefore, newly used to analyze the data based on the content of newly graduated nurses who work in a rapidly changing work graduated nurses’ thoughts and experiences regarding environment need mentorship and long-term support entering the nursing profession [18,19]. that provide conditions to increase their self-confidence and independence [6,14]. Data collection The expectations regarding newly graduated nurses’ A small convenience sample that is appropriate clinical skills and responsibility to handle patients con- for qualitative methods was used [20]. The inclusion tribute to occupational stress. Interprofessional team- criteria for participation were registered nurses over work is therefore emphasized to manage a high quali- the age of 18 years with the ability to understand ty of care [15]. However, teamwork requires a healthy and speak Swedish and involved the basic year (4-12 work environment [14], i.e., a supportive culture and month experiences from June 2017-March 2018) in a opportunity for reflection at work [13,16]. Therefore, medical department (medical ward, emergency unit) at the transition from student to registered nurse is chal- Sahlgrenska University Hospital. Two of the authors (EI, lenging as theoretical knowledge is translated into prac- JV) sent out an inquiry and an informational letter by tical settings. For this reason, the current study intends email

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